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1780718072 NPI number — JOSE R MELENDEZ M.D

NPI Number: 1780718072
Health Care Provider/Practitioner: JOSE R MELENDEZ M.D

Information about “1780718072” NPI (JOSE R MELENDEZ M.D) exists in 1780718072 in HTML format HTML  |  1780718072 in plain Text format TXT  |  1780718072 in PDF (Portable Document Format) PDF  |  1780718072 in an XML format XML  formats.

NPI Number : 1780718072 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1780718072",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "MELENDEZ",
    "FirstName": "JOSE",
    "MiddleName": "R",
    "NamePrefix": "DR.",
    "NameSuffix": null,
    "Credential": "M.D",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "MELENDEZ",
    "OtherFirstName": "JOSE",
    "OtherMiddleName": "R",
    "OtherNamePrefix": "DR.",
    "OtherNameSuffix": null,
    "OtherCredential": "M.D",
    "OtherLastNameTypeCode": "5",
    "FirstLineMailingAddress": "3636 CALLE CUMBRE",
    "SecondLineMailingAddress": "URB. EL MONTE",
    "MailingAddressCityName": "PONCE",
    "MailingAddressStateName": "PR",
    "MailingAddressPostalCode": "00716-4834",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "787-643-6152",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "3636 CALLE CUMBRE",
    "SecondLinePracticeLocationAddress": "URB. EL MONTE",
    "PracticeLocationAddressCityName": "PONCE",
    "PracticeLocationAddressStateName": "PR",
    "PracticeLocationAddressPostalCode": "00716-4834",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "787-643-6152",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "03/16/2007",
    "LastUpdateDate": "05/06/2015",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "208000000X",
        "TaxonomyName": "Pediatrics Physician",
        "LicenseNumber": "6153",
        "LicenseNumberStateCode": "PR",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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